The focus of health and wellness professionals today is on disease and problems – in other words, what’s wrong (negative health). Wouldn’t you rather be focusing instead on positive health, or in other words, what’s right?
Health today has a disease focus – a focus on risk reduction, avoidance, prevention and treatment of disease, infirmity and disability. This focus stems, no doubt, from medicine and its focus on pathogenesis, which is the study of the origin of disease. In a pathogenic model – health is measured by the incidence of disease or health related problems. Success in the pathogenic model is measured by the avoidance or elimination of problems, diseases and premature death.
Health is often depicted as being a continuum, with one end being premature death and the other end being wellness. The mid-point of the continuum is often described as being a neutral point where no discernible illness or wellness can be detected. If success in the pathogenic model is the avoidance or elimination of problems or disease, then success in this case this does not create a state of wellness, but instead a point there is no discernible illness or wellness. The betterment of health or the movement towards wellness would then require that deliberate, specific concrete actions to be taken.
The necessity of taking deliberate, concrete action to achieve optimal health, positive health or high level wellness would be consistent with what researchers have found in other areas. Researchers have shown that eliminating negatives alone does not, in and of itself, create positive conditions. Some examples that demonstrate what I am saying would include:
• Herzberg who showed that eliminating dissatisfaction does not create satisfaction
• Compton who showed that eliminating depression does not create joy
• Seligman who showed that mental health was not the mere absence of mental illness
• Becker and colleagues who showed that ending disease does not create positive health
Instead of aiming for a return to neutral or the status quo, a focus on positive health moves our focus towards outcomes that exceed our expectations, in other words, our idealized outcomes.
Positive health has its roots in the salutogenesis model. Salutogenesis provides a focus and methodology to discover and develop the causes or origins of positive health. Salutogenesis complements pathogenesis by working to optimize health and well-being through continuous and never-ending improvement. Salutogenesis is about how to add positive actions, opportunities, conditions and outcomes to move us beyond the neutral point to higher, positive levels.
Positive health is a deliberate consciouly created dynamic state. Positive health has also beed described as well-being, thriving or flourishing.
To achieve and continually improve positive health, a supportive, nurturing and encouraging environment must be consciously and thoughtfully developed and continuously improved. This supportive and nurturing environment is a necessary ingredient in the behavior change process.
Positive states are created through deliberate, conscious effort and action. To create positive states, specific efforts must be taken that go just beyond the elimination of health risks and problems. These specific efforts need to be supported through the use of following 9 Es and 1 C:
Use these 9 Es and 1 C in your worksite wellness program to help your employees achieve positive health.
If you are interested in reading more, consider these references:
Antonovsky, A. (1979) Health, stress and coping. San Francisco, CA: Jossey-Bass.
Becker, C. M., Dolbier, C.L., Durham, T., Glascoff, M. A., & Adams, T.B. Development and preliminary evaluation of the validity and reliability of a positive health scale. (2008). American Journal of Health Education, 39(1), 34-41.
Becker, C. M., Moore, J., Whetstone, L., Glascoff, M., Chaney, E., Felts, M., & Anderson, L., (2009). Validity Evidence for the Salutogenic Wellness Promotion Scale (SWPS). American Journal of Health Behavior, 33(4), 455-465.
Becker, C., Glascoff, M., & Felts, W. (2010) Salutogenesis 30 years later: Where do we go from here? International Electronic Journal of Health Education, 13, 25-32.
Compton, W. C. (2005). Introduction to positive psychology. Belmont, CA: Wadsworth.
Dunn H. L. (1961). High-level wellness: A collection of twenty-nine short talks on different aspects of the theme “High-level wellness for man and society.” Arlington, VA: R.W. Beatty Co.
Herzberg F. (2003). One more time: How do you motivate employees? Harvard Business Review, 81(1), 86-96. (Original work published 1968).
Seligman, M. E. P. (2008). Positive health. Applied Psychology, 57(s1), 3-18.